Myths and Facts About Implants After Breast Cancer

Joseph Serletti, MD, FACS, and his patient, Jackie, talk about why breast reconstruction following a mastectomy is integral to the holistic treatment of breast cancer.

Breast implants are one of the ways plastic surgeons can create a reconstructed breast after a mastectomy, the term for when all of your natural breast tissue is removed, or in some cases, after a lumpectomy, which removes only the tumor and an area of normal tissue around that.

There are a lot of misconceptions about breast reconstruction after cancer.

Myth #1: Reconstructive surgery is a one-and-done procedure.

Fact: “It may take multiple surgeries to get to the point where you can achieve the look that you want,” clarifies Dr. Wu.

Your plastic surgeon reconstructs your breast after a mastectomy by taking a woman’s muscle in her chest, which is not removed during the mastectomy, and moving that muscle directly underneath the skin.

Then, a breast implant is placed under the muscle. A normal breast has breast tissue on top of the muscle.

“The first surgery would be the mastectomy and placement of tissue expanders underneath the muscles of the chest,” Dr. Wu explains. “Then, the patient undergoes a series of expansions to stretch the skin and muscle to create a pocket.”

Expanders are balloon-like sacs that slowly expand to the desired size of a reconstructed breast.

The second surgery involves removing the expanders and putting the breast implants in, while the third surgery is the nipple reconstruction phase. Nipple reconstruction is when a plastic surgeon builds a new nipple using tissue from your body or donor skin.

“But not every woman needs every stage done,” adds Dr. Wu.

Myth #2: Once an implant is in, it's a lifelong device.

Fact: “All implants will eventually break, so there’s a finite lifespan to the implants,” says Dr. Wu. Typically, that happens within 10 to 15 years.

Implant rupture rates are approximately one percent per year but go up after 10 years. One can expect your implant to last approximately 10 to 15 years. Since a woman may not always feel or see when a rupture in her implants has occurred, magnetic resonance imaging (MRIs) may be needed every few years to monitor for any sign of trouble.

It is also imperative that you follow with your plastic surgeon regarding your implant based breast reconstruction. Other than rupture, there can be other potential complications like infection, capsular contracture, or even a rare lymphoma associate with implants, that should be assessed periodically by your surgeon.

Myth #3: If you have a breast reconstruction, it will be hard to detect breast cancer in the future.

Fact: “There’s no evidence that shows breast reconstruction of any kind will deter cancer detection,” Dr. Wu asserts. “Patients have to continuously undergo surveillance for the rest of their lives, even though they’ve had a mastectomy.”

She adds there is also no worry that breast reconstruction would trump what’s needed for breast cancer treatment: “We never delay any kind of breast cancer treatment for breast reconstruction. That’s your main goal—to treat your breast cancer—so breast reconstruction should never take precedence over breast cancer treatment.”

Myth #4: Not every woman is a candidate for breast reconstruction.

Fact: “No matter what point you are at during the course of your treatment or what you’ve had done, most women are still candidates for breast reconstruction,” Dr. Wu explains.

Even if you’re not ready to get your reconstruction, you should still meet with a plastic surgeon to review your options. It can be done at the same time as a mastectomy or delayed afterwards. And if you've had a mastectomy, it will be covered by insurance.

“Breast reconstruction is part of the healing process,” Dr. Wu says.

Myth #5: Implants are the only option for reconstruction.

Fact: "While most women qualify to get breast implants for their reconstruction, other methods exist," says Dr. Wu.

An option besides implants is getting tissue from other parts of your body—such as the abdomen, buttocks, or back—and using that to create a new breast.

“The various options available for reconstruction are very different,” Dr. Wu explains. “Each has a different length of surgery, different recovery times, different outcomes. So, patients should discuss with their doctor which may be the better option.”